Tag: travel speech therapy

“Couldn’t I just cut out the middle man and negotiate my own contracts?”

Have you ever thought about this before? Have you considered trying to set up your own travel therapy contracts instead of working through a travel agency? If so, you’re not alone.

Whether to take travel therapy contracts through a travel company or to work as an independent contractor through a business entity as a 1099 employee is a question we’ve received quite often. This is a very valid question, considering we all know that travel companies keep a percentage (sometimes a significant amount) of the bill rate that the facility pays the travel company.

If you’re completely unfamiliar with bill rates, then this article should give you baseline knowledge to better understand the calculations that I’ll go through to compare taking jobs through a travel company or as an independent contractor.

Financially, on the surface the answer seems obvious, but upon investigation it gets much more complex as to which choice is more lucrative. Since I’m a finance nerd and all for optimizing income, I initially planned to eventually go this route myself, cutting out the middle man so to speak in order to keep more of the hard earned travel pay. I dug deep into the tax laws and ran calculations to see just how much more I would actually be able to make as an independent contractor instead of taking jobs though a travel company.

What I found surprised me and made me decide it wasn’t worth the hassle, and since then Whitney and I have continued to take travel contracts through travel companies. Let’s explore how I came to this decision and help give you some food for thought as to whether this is a possible option for you, complete with plenty of math! 🙂

Pros and Cons of working as an Independent Contractor on Travel Assignments

The main benefit of working as an independent contractor, and the reason that just about everyone that goes this route decides to do it, is to keep the entire bill rate like I mentioned above and make more money! Instead of the travel company keeping 20-25% of the bill rate, you get to keep it all! What’s not to like about that?

The downsides will vary from person to person, but generally include: establishing a business entity (most people seem to prefer an LLC for this to reduce potential personal liability), more hassle finding assignments (you have to do this all on your own of course), writing your own contracts or being able to understand the ins and outs of contracts written by the facility, being responsible for getting your own health insurance, being responsible for getting your own liability insurance, having to pay self-employment tax on income, and having no one to advocate for you. Let’s explore each of these downsides individually.

Establishing a business entity: For this, it is best to consult a professional for advice on which business entity would be best for your situation. As much as I hate spending extra money, if I was going to go the independent contracting route this is an area where I wouldn’t cut corners. Being sure that you’re doing everything by the book is not only the best way to avoid future issues, but will also help you sleep better at night.

More hassle finding assignments: When working with a recruiter, you will be presented with potential jobs options from their clients (facilities) with current therapist needs. As an independent contractor, you have to do all of this on your own which usually involves “cold calling” clinics in the area that you’re looking for a job, or looking at permanent position job openings in the area and reaching out to them to see if they would consider a traveler. This is going to be more time consuming than having the jobs presented to you by a recruiter. In addition, some facilities that need travelers often choose to work with only one specific travel company to help streamline the process, which means those jobs might not be available to you even if you contact them directly and are a good fit.

Writing your own contracts: When you find a facility that is willing to hire you as a traveler, you’ll either need to write your own contract to have them sign or possibly sign a contract that the facility has. This is an area where you want to be careful since legal contracts can have very specific wording, and it’s easy to miss something if you don’t pay attention. As an upside, this would probably only be an issue for the first couple of contracts as an independent contractor since you’ll almost certainly become more proficient with writing and reading contracts over time.

Being responsible for your own health, dental, and vision insurance: This is a big one. As an independent contractor your yearly pay will almost certainly be high enough to disqualify you for ACA tax credits, which means you’ll be responsible for the full premium amount if you get health insurance through the marketplace. The travel company pays for a portion of the usual premium for us, which is why the company sponsored plans are so much cheaper than plans through the marketplace.

Being responsible for your own liability insurance: This is a relatively minor cost but not something to overlook. Travel companies provide liability insurance for their travelers, but if you are working as an independent contractor then you’ll have to get this on your own. In general this shouldn’t cost more than a few hundred dollars per year.

Paying self-employment tax on income: This is another big one! Self-employment tax is the money paid toward Medicare and Social Security on your behalf. This amounts to 15.3% of your income right off the top, and you can’t avoid it even with retirement account contributions! When working as an employee through a travel company, they would pay for half of this tax on your behalf with you only paying 7.65% (denoted as FICA taxes on your pay stub), but when working as an independent contractor you’re responsible for the whole shebang. For more detail on this tax, check out this link.

Having no advocate: Your recruiter (as long as they are good) is a lifeline for you while on assignment. If you have issues with a facility, then they can be the one to have the tough talks with the facility regarding fixing things if you aren’t comfortable doing that. If a contract goes exactly according to plan, then this may not be important at all, but if you end up at a facility where things aren’t ideal then this could prove to be very valuable and significantly reduce your headache.

Yeah, Yeah… But More Money!

I hear you! Despite all the “cons” mentioned above, I was ready to accept all of that and still work as an independent contractor if it meant an extra few hundred dollars per week, and this may be what you’re thinking as well.

However, I was very disappointed to find out that for my and Whitney’s situation, the financial benefit was actually very little or even nonexistent in some cases!

How can that be if the travel company isn’t keeping 20-25% of the bill rate? That’s where the math comes in.

Before we jump into the calculations though, let me explain how that 20-25% extra can quickly evaporate.

Stipends (Per Diems):First I want to make it clear here that I’m not a tax professional. The information below is just my understanding of the tax laws as I’ve read them and from what I’ve learned from consulting with tax professionals. Always consult with a professional before making a decision based on what is written here! TravelTax is a wonderful resource for more information. With that being said. The big thing that makes being a travel therapist so lucrative are the stipends for those travelers who meet the requirements for maintaining a proper tax home (the vast majority). The biggest portion of those stipends is almost always for housing. On average our housing stipend has been in the $600-$700/week range while traveling depending on the location. When working through a travel company, this amount can be received even if your actual travel housing doesn’t cost doesn’t equal the full amount. While working as an independent contractor, even though you can write off your housing expense, it can only be for the actual cost of the housing incurred. What that means is that if you find low cost housing at your travel assignment, you’ll only be able to deduct the actual cost of the housing instead of being able to receive the much larger housing stipend that you would when working through a travel company. This is the single biggest reason why working as an independent contractor doesn’t make sense for Whitney and me. The most expensive housing that we’ve had to date on an assignment was $900/month, with the average being closer to $650/month. Divided between the two of us, we’d only be able to write off an average of $325/month each for those housing costs if we worked as independent contractors versus the $600-$700/week ($2,500-$3,000/month) that we each get when working through a travel company. Luckily, the full meal and incidental stipends would still apply to independent contractors just like they do for travelers working through a travel company, so no difference there. But, depending on your average cost of housing on assignment, missing that full housing stipend can be huge as we’ll see in the calculations later.

Self-Employment tax: As mentioned above, this amounts to an additional 7.65% of income paid off the top in taxes when working as an independent contractor compared to when working through a travel company. This becomes even more significant than it appears at first glance due to the higher taxable pay as an independent contractor.

Health insurance: Paying the full marketplace premium for insurance is going to be much more expensive than the insurance offered through a travel company in almost all cases. For example, on my last contract my health, dental, and vision insurance premiums through the travel company we used cost me $24/week. For comparable coverage purchased through the marketplace, I would have to pay about $120/week. That’s over $400/month more for insurance when working as an independent contractor!

Onto the Numbers

Now that we see some of the reasons why the pay actually received as an independent contractor may not be as high we initially anticipated, let’s do some calculations to see if the actual difference would be worth the other “cons” mentioned above.

I’m going to use my situation on my most recent contract as an example, but keep in mind that this will differ for everyone depending on your own variables. I don’t know what the actual bill rate for that contract was since this is usually not disclosed by the travel company, but I’ll go through two examples using a $60/hour and a $65/hour bill rate which seem to be pretty typical on the east coast in our experience. I’ll also use 25% as the travel company margin, which would typically be on the high end but it depends on the specific company and contract.

The Scenario: 30 year old male, working 40 hours per week, for 48 weeks per year, with both the contract state and the home state being Virginia, working in Fredericksburg. Housing cost of $800/month, split with Whitney ($400/month each).

Working through a travel company taking 25% margin from $60/hour bill rate

Total yearly taxes (determined using this calculator): $30,080 (of which $13,244 is self-employment tax)

Total yearly after taxes: $115,200 – $30,080 = $85,120

$85,120 / 48 weeks = $1,773/week take home after taxes

– $120/week health, dental, vision insurance premium

=$1,653/week take home after insurance premiums

As you can see here, as an independent contractor in the situation, weekly take home pay would only be about $35 more per week when everything is said and done!

Now let’s look at the same exact scenario, but with a maxed out 401k each year in both cases since that will help reduce the taxable income (on everything except self-employment taxes) which is very beneficial with such a high income as an independent contractor.

Working through a travel company taking 25% margin from $60/hour bill rate with maxed out 401k contribution ($19,000)

Total yearly taxes (determined using this calculator): $24,808 (of which $13,244 is self-employment tax)

Total yearly after taxes: $115,200 – $24,808 = $90,392

$90,392 / 48 weeks = $1,883/week take home after taxes

– $120/week health, dental, vision insurance premium

=$1,763/week take home after insurance premiums

As we can see here, maxing out a 401k account helps to reduce taxes on the income, which benefits the independent contractor more than the traveler working through a travel company.

So in this scenario after the 401k contributions, the independent contractor would come out $75/week ahead of the traveler working through a travel company.

If I did ever change my mind a pursue traveling as an independent contractor, I would definitely take advantage of the tax deferred savings associated with a 401k to reduce the tax burden on the higher taxable pay. An extra $75/week would amount to only about $300 more per month or $3,600 more per year. That’s still not worth the “cons” mentioned earlier in my opinion.

The pay difference between working as an independent contractor compared to working through a travel company only narrows further as the bill rate increases. This is because as the bill rate increases, the housing stipend can also be increased. This is of course as long as the GSA allows room for additional money applied to the housing stipend without going over the limits for the area that you’re traveling in. In the case of the independent contractor, their housing price doesn’t change just because the bill rate is higher, so the deduction for housing stays the same.

To illustrate this, let’s run the same calculations using the same scenario with a $65/hour bill rate.

Working through a travel company taking 25% margin from $65/hour bill rate

Total yearly taxes (determined using this calculator): $28,940 (of which $14,712 is self-employment tax)

Total yearly after taxes: $124,800 – $28,940 = $95,860

$95,860 / 48 weeks = $1,997/week take home after taxes

– $120/week health, dental, vision insurance premium

=$1,877/week take home after insurance premiums

After the reduction in taxable income through the 401k contributions in this final example, the independent contractor would come out ahead by a whopping $39!

Additional Considerations

In the example above, I did not account for the cost of liability insurance in the independent contractor example, because this cost is negligible in most situations and just adds further complexity to the calculations.

In addition, I did not factor in reimbursements for travel expenses that most travel companies will give in addition to the weekly pay. The reason for this was that an independent contractor would be able to deduct that expense as well, and those are likely to cancel each other out, especially in the scenario I laid out above where travel to and from the assignment location from my tax home was only a few hours each way. If this had been a move across the country, and the travel company didn’t reimburse those full expenses, the independent contractor would at least be able to deduct those beginning and ending travel expenses, whereas the traveler working through a company wouldn’t be able to due to the tax law changes last year in The Tax Cuts and Jobs Act (TCJA). That would skew things more in favor of the independent contractor, but by how much would depend on the actual beginning and ending travel expenses incurred.

I did not include the 20% pass through deduction that was also part of the TCJA last year due to uncertainty whether that would apply to all travelers in this situation. If this does indeed apply to your business entity as an independent contractor, then that extra 20% deduction would significantly improve the financial aspects of traveling as an independent contractor. Be sure to consult with a CPA on this deduction if you do decide to work as an independent contractor through your own business entity.

Single travelers that will be working in higher cost of living areas where housing costs are likely to be much more expensive will have a much higher deduction than in the above example for housing expenses incurred while working as an independent contractor. A much higher housing cost will tilt things more in favor of traveling as an independent contractor and is something that should be considered if this applies to you.

The higher taxable pay associated with working as an independent contractor will lead to much higher monthly student loan payments for anyone that has chosen to go with an income driven repayment plan. If you plan to pay your loans off as quickly as possible while traveling by making much larger payments, then this won’t affect you at all. If you plan to pay the minimum, save/invest the difference, and potentially go for 20-25 year student loan forgiveness, then this could be a big potential downside in going the independent contractor route, especially while on REPAYE and having half of the accumulated interest subsidized each month which is the case for me.

Conclusion

Cutting out the middle man and taking travel jobs as an independent contractor to make more money is certainly enticing, but upon investigation it proves to be more hassle and less lucrative than it appears at first glance.

The actual financial benefit of going this route can very drastically depending on the individual and his/her situation, but for Whitney and I, it does not seem to be worth it. This is only a path that I would personally consider if it meant an increase in at least $200/week after taxes, otherwise I don’t think that it’s worth the extra work involved. For us, it’s clear in the above scenarios that it would not be.

If you do decide to go the independent contractor route, maxing out pre-tax accounts (401k, traditional IRA, and HSA) all become ever more attractive options as a means to reduce taxable income and therefore significantly reduce taxes.

If you’ve worked as an independent contractor as a traveler in the past, we’d love to hear about your experience and if it differs from the cases I’ve laid out here. Let us know in the comments or send us a message.

If after all of this, you’ve decided that working as an independent contractor isn’t for you and would like recommendations for recruiters/companies that pay well and that we trust, then reach out to us here! Thanks for reading and I hope that this was helpful to you in deciding the best travel therapy path for you.

For PT’s, OT’s, SLP’s and assistants interested in taking travel contracts working with pediatrics, sometimes these jobs can be harder to come by than other settings. The most common settings available for travel positions include home health, SNF, acute, and outpatient orthopedics. But for those looking to work in peds, school contracts may be a great option!

You might be wondering how school contracts are set up for a traveler. Do you have to work the full school year? What is the pay like? Do you get paid during school breaks? Since this setting is a bit different than others, we wanted to provide some key information to working in school contracts as a traveler.

The Basics of Working School Contracts

Most school contracts will typically be for the full school year, but some schools are open to just doing half the school year with the possibility of extending, or a little less than that even. Every situation is different, so if you’re unsure if you want to commit to a full year, work with your recruiter and the facility to find out what’s possible.

When school jobs are listed with an “ASAP” start date and it’s the middle of the school year, that contract would be from now or as soon as you could start, until the end of this school year. If you see a job listed with a July or August start, that would be for the upcoming school year.

Schools will typically have a very low facility cancellation rate, making it a pretty stable commitment on your end. This is helpful to know because as a traveler, you need to consider planning your housing for the duration of the contract.

The typical hours you will see for a school contract are between 35-37.5 hours per week. There are some contracts with 40 hour weeks, but it’s not usually the norm. Although most are not 40 hour guarantees, the rates are usually a bit higher in this setting which can help to offset the lower hours. This may bring your weekly take home to be similar or even better than a normal 40 hour work week in another setting.

A cool perk to working in schools is you have all of the school holidays off, so you know your days off in advance, and they are setup around desirable holidays/days people want to take off anyways. The uncool part of this, is you may not get paid during school holidays. So you will have to plan accordingly around this.

If you are off for the entire week for a school holiday (such as Spring Break or Winter Break), you will not be paid at all for that week. However, if you are off for only part of the week for the holiday, you may still receive your full week’s per diems, or part of the week’s per diems, in addition to the hourly pay for the days you did work. It’s important you clarify this with your travel company to understand how your pay will work around school holidays.

What Disciplines Are Most Needed?

The majority of school positions tend to be open for SLP, but there are options for PT’s, OT’s, PTA’s, and COTA’s as well. The market can vary across different states and school districts with different needs.

School positions often accept and support CF SLPs as well. However, this may or may not be a desirable setting for a lot of SLPs coming out of school that may be more interested in medical job settings.

What Questions Should I Ask During an Interview?

Not all travel therapy school positions are created equally. There are some important questions you should consider asking during your interview to decide if a contract is right for you, which might include:

How many children will be on caseload?

Who are the other staff members? (PT, OT, SLP, aids, etc.)

Have you had a travel therapist there before?

What is the facility like? (equipment, etc.)

What will my hours be?

Will I be covering more than one school?

What age groups will I be covering?

What Are Some Pros & Cons to Working School Contracts?

There are some benefits to working in schools pertaining to taking a longer (full school year) contract, which include more job stability; moving less often between contracts (as opposed to the typical 13 week travel contract); exploring an area for a longer period of time; and potentially saving on housing costs with a longer lease.

Another benefit is that you have planned time off to be able to take trips, and this time off is usually around holidays when you may want to spend time with family and friends.

Another potential benefit would be building your skill set in a different setting. This could be especially important with pending changes in Medicare, which could affect the market for settings such as Skilled Nursing Facilities.

However, for some people, there could be cons to taking a school contract. Some may consider committing to a full school year as limiting their ability to travel and see the country. They may also have fear of getting locked into a long contract without knowing if it’ll be the right fit for them. Fortunately for this concern, we as travelers have the option of a 14 or 30 day cancellation notice if placed in a bad situation.

Another con can be the paperwork and IEP meetings involved in working in schools. As with every setting, you have to take into consideration the documentation and meetings involved, which is the not-so-fun part of our jobs as healthcare providers.

And the last consideration would be not getting paid during school holidays. This may require some additional budgeting on the traveler’s part, or working with the recruiter to rearrange the pay package as needed. But for many travelers who tend to take a week or so off between their normal 13 week travel contracts to travel for leisure, relax and recharge, or go home to visit family and friends, these school breaks can provide the same thing, just structured a bit differently.

Is a School Contract Right for You as a Traveler?

Some clinicians absolutely love working with pediatrics and in the school setting. For others, this may be a totally new experience. As with any travel therapy job, you will have to take into consideration many factors when choosing if a particular school contract is right for you.

If you have questions or would like help getting started with your travel therapy journey, please contact us!

Home health can be a great option for travel therapists due to the abundant need for therapists to serve patients in this setting. If you are willing to take home health contracts, options for locations will open up dramatically at any given time, and usually you can command even higher pay than normal. To see if home health may work for you, check out my pros and cons article here.

Since home health is a bit different than other settings, you may be wondering what things you should look for in a home health contract and what questions you should ask in an interview for this setting. Here is a more in depth look at some important aspects of a home health contract that you should consider:

Training:

Find out how much training will be provided by the company. This is especially important if you don’t have prior experience in this setting.

Tips during training: Take the computer from your trainer and document as much as possible. You know how to be a therapist, but as I mentioned in the pros and cons article, there is a lot of documentation in home health, so you really want to start getting familiar with the system as soon as possible.

Of course, you should also pay attention to the differences in care that you’ll be providing in home health because there are some important safety issues to take note of during evaluations, but otherwise the therapy you’ll be providing is similar to other settings.

In our experience, my wife Julia and I have received about two weeks of training at the home health contracts we have taken.

Points system:

You want to find out how their productivity works, and if it’s on a points system vs. hourly vs. purely based on number of visits regardless of type. This is an important measure of productivity that is different from every other setting. Your company may assign a certain number of points to each type of visit based on the length of time they predict this visit taking (I am sure that it is also based on the reimbursement from insurance).

For example, the last home health contract we did had the following points system:

2.5 points for start of care/OASIS

1.5 points for evaluation

1.25 for discharge

1 point per regular visit

In a 40 hour week we were expected to complete 30 points at that company. The numbers generally are similar to these from what I have heard from others. This is also how many full time and PRN employees are paid in home health instead of hourly/salary.

Travel Radius:

You want to find out how far you will be expected to drive and what areas you will be covering for your home health visits.

This is going to be the number one factor outside of your personal efficiencies with documentation and planning that is going to affect your productivity capabilities.

At our first contract, our travel radius was very similar and only about 15 miles from the office for either one of us. At our second contract, my radius stayed about the same, but the majority of my patients were located in a 10 mile radius of the city in my territory; while Julia’s was a larger territory, probably 20 miles, and her patients were more spread out as there was no main city in her territory.

This is something that is hard to figure out before you take a contract. We didn’t even know exactly where our territories were going to be when we took our second contract due to the huge territory the company covered. There were many days where I would only drive 15-25 miles in total, and Julia would drive 50-60 miles.

Obviously the more you drive, the tougher it is to hit your productivity standards. Your best bet is to ask how many miles you can expect to drive in a day/week in the interview. You can also ask around to find out about the area and the traffic before committing.

Mileage Reimbursement:

Find out if they reimburse for mileage and how much.

We do not recommend you take a home health position unless they are going to reimburse you for mileage.

You want to be making at least 50 cents per mile no matter what, and personally if I ever do home health again I will demand the government rate of 58 cents per mile. The mileage is not only for your gas consumption, but also for the wear and tear on your vehicle. If you are planning to do home health for an extended period of time, getting a fuel efficient vehicle is highly recommended as well.

These are a few of the key factors you want to consider when looking into taking a home health contract as a travel therapist. Home health can be a rewarding setting to work in, especially because it can be flexible for your lifestyle. But you want to make sure to ask the right questions so that you won’t be stretched too thin when it comes to number of visits, driving radius, gas, and wear and tear on your car. If you have more questions about working in home health, or have a specific job offer you’d like to discuss with us, please reach out to us for mentorship!